Clinical commissioning forum
Summary notes – Thursday 1 December 2017
Community ENT service
- The community ENT service provides fast access to specialist care for patients within City and Hackney aged over 16 years.
- The governance team manages referrals and meets on a monthly basis – the team is managed by Gemma.
- Completed referral forms should be sent directly to – their contact phone number is 020 3879 0135.
- The service works out of two locations (Tynemouth Medical Practice and Nightingale Practice), they looking for another location – if you think you might have a room available please let Kevin know.
- The community ENT service will run some education sessions next year – Kevin asked GPs if they would prefer a Friday education session or smaller consortia based sessions – the group said they would prefer consortia based sessions.
- More information, referral forms and contacts are on the CCG website.
Immunisations for pregnant women
- There is a low uptake of pregnant women getting their pertussis and flu immunisations – we are working with HUH to give the immunisation at their 20 week scan
- Tamsin from HUH attended the meeting to give an overview of the service HUH is running
- The Homerton maternity service has employed two nurses to deliver pertussis and flu immunisations to pregnant women, right after their 20 week scan
- If you immunise,please writein the women's maternity notes (blue book)orgive the pregnant woman a note to pop intoblue bookif she doesn't have it with her,so the midwives know they have had their jabs
Registering vulnerable patients
GP Registration for Offenders London
- Julie Rhymes attended the meeting in place of Leighe Rogers to talk about the problems offenders have getting registered with a GPand a new scheme they are working on to get offenders registered with a GP before they leave prison to make a smoother transition for them.
- Offenders have complex health problems including TB, diabetes, epilepsy, significant mental health issues and substance misuse.
- They often find it hard to register with a GP because they are homeless and have poor communication skills – they also find there are barriers in the way they are treated when they get to a GP service.
- Previous offenders are frequent attenders at A&E because it’s easier for them – they are 40 times more likely to not be registered with a GP.
- The scheme will work by: checking and recording GP status when offender comes into the system, prison healthcare share with probation team, offender manage completes an NHS GP registration form, offender manager identifies a GP practice and sends referral letter and NHS registration to practice.
- This scheme has been rolled out to London prisons and they are currently rolling it out to probation services.
- You can help these people by being welcoming, showing understanding, being flexible, and showing patience.
Entitlement to Healthcare for refugees and vulnerable migrants in the UK
- Anna from Doctors of the World attended the CCF to talk about the barriers refuges and migrants face when registering with a GP.
- Doctors of the World run a clinic in Bethnal Green serving 1600 patients – on average migrants and refugees are in the UK for 6 years before they will register with the NHS.
- Everyone in the UK no matter what their visa status is entitled to use the NHS.
- The biggest reason for refugees and migrants not registering with the NHS is that they haven’t even tried because of perceived barriers.
Devolution update
- The CCG Chief Officer, Chief Financial Officer and LBH Group Director presented the business case to the London Devolution Board on 4 November – you can view a copy of the business case on the CCG intranet
- The next step is to negotiate our three main asks which were: (1) licensing powers to support prevention, (2) the power to manage our own estates and (3) changes to section 75 legislation to support joint commissioning with local authorities – there is a meeting tomorrow about this
- We are planning to develop integrated commissioning arrangements between our CCG and the 2 local authorities by 1 April 2017 – this is the best way to preserve local decision making
- One GP expressed concern about GPs having a voice and wanted to know if we would retain the CEC and consortia – Paul (CCG Chief Officer) advised that there is no plan to make any changed to CEC and consortia
Delegated commissioning of primary care and GP forward view
- The Governing Body has agreed to submit an application for level 3 delegated commissioning subject to:
-gateway checks:
-due diligence process:
-feedback from stakeholder engagement
- This application can always be withdrawn if we change our minds
- One GP expressed that there need needs to be better clarification around governance
- One GP asked when practices would get an increase in list size? The budget will change accordingly to the population.
- One GP asked if it was reasonable to ask what skillset the people who will sit on the new primary care committee have - below is a list of the proposed members:
-Lay Member (Honor Rhodes)
-Associate Lay Member (Jaime Bishop)
-Governing Body Consultant (Christine Blanshard)
-Governing Body Nurse (Siobhan Clarke)
-City of London HealthWatch Representative (Gail Beer or alternative)
-London Borough of Hackney HealthWatch Representative (Jon Williams or alternative)
-CCG Chief Officer (Paul Haigh)
-CCG Joint Chief Financial Officer (Sunil Thakker)
- The following individuals will also be invited to attend as a matter of course, but they will not have a vote on any part one Committee decisions:
-Independent GP Advisor (Dr Mike Fitchett)
-London Borough of Hackney Health and Wellbeing Board Chair (Cllr Jonathan McShane)
-City of London Corporation Health and Wellbeing Board Chair (Deputy Joyce Carruthers Nash)
-Director of Public Health (Penny Bevan)
-NHS England Head of Primary Care (North East London Region) (Ceri Jacobs)
-NHS England Assistant Head of Primary Care (North East London Region) (Alison Goodlad)
-CCG staff to provide technical advice as required.
- You can view a full summary of the role and makeup of the Local GP Provider Contracts Committeehere.
- City and Hackney CCG governing body member’s biographies can be viewed from page 32 of our 2015/2016 annual report
GP IT update
- The IT steering group are currently working on:
-Increasing the use of HIE, the usage is up but there are 4 practices not using it at all
-Increasing e-referrals
-Getting the e-discharge, OPC and comms letters active
-Developing a new GP intranet
- There were a lot of questions around information exchange and having to get patients permission to view their files each time – there are a lot of issues around consent, the group were advised to follow information governance guidance
- There was also mention of getting content from each patient at the time of them registering – this way they would only need to ask once rather than each time
- Our GP intranet does more now than it was initially built for so it’s not fit-for-purpose anymore – we are going to revamp it and get something more user friendly
- One GP mentioned that the GP confed has paid for something (maybe a new intranet) so we should check with them before spending any money
- You can read the full GP IT update here.
CMC Quality of Care Plans
- Since CMC was launched via EMIS in April 2016 there has been a bit increase of care plans on CMC – City and Hackney are one of the biggest inputters
- 950 patients in City and Hackney have had CMC records created
- GP question – how do you print to give to patient? You can’t print through EMIS – check this guide for information on how to get around this.
- GP question – where do you put ‘contact ParaDoc’? You can enter this under sealing of treatment of under contacts.
- CMC are piloting a new function which will allow patients to look at their own CMC urgent care plan online – more information about this pilot was highlighted in the CCG newsletter, if you are interested in participating in the pilot please email